Guidelines

Guideline on the Assessment of Cardiovascular Risk

The “2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk” provides clear recommendations for estimating heart disease risk. Risk assessments are extremely useful when it comes to reducing risk for heart disease because they help determine whether a patient is at high risk for heart disease, and if so, what can be done to address any cardiovascular risk factors a patient may have. Here are the highlights of the guideline:

Risk assessments are used to determine the likelihood of a patient developing heart disease, heart attack or stroke in the future. In general, patients at higher risk for heart disease require more intensive treatment to help prevent the development of heart disease.

Risk assessments are calculated using a number of factors including age, gender, race, cholesterol and blood pressure levels, diabetes and smoking status, and the use of blood pressure-lowering medications. Typically, these factors are used to estimate a patient’s risk for developing heart disease in the next 10 years. For example, someone who is young with no risk factors for heart disease would have a very low 10-year risk for developing heart disease. However, someone who is older with risk factors like diabetes and high blood pressure will have a much higher risk of developing heart disease in the next 10 years.

If a preventive treatment plan is unclear based on the calculation of risk outlined above, doctors should take into account other factors such as family history and c-reactive protein. Taking this additional information into account should help inform a treatment plan to reduce a patient’s 10-year risk of developing heart disease.

Calculating the 10-year risk for heart disease using traditional risk factors is recommended every 4–6 years in patients 20–79 years old who are free from heart disease. However, conducting a more detailed 10-year risk assessment every 4–6 years is reasonable in adults ages 40–79 who are free of heart disease. Assessing a patient’s 30-year risk of developing heart disease can also be useful for patients 20–59 years of age who are free of heart disease and are not at high short-term risk for heart disease.

Risk estimations vary drastically by gender and race. Patients with the same traditional risk factors for heart disease such as high blood pressure can have a different 10-year risk for heart disease as a result of their sex and race.

After doctors and patients work together to conduct a risk assessment, it’s important that they discuss implications of their findings. Together, patients and their doctors should weigh the risks and benefits of various treatments and lifestyle changes to help reduce risk for developing heart disease.